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Outcomes of Urinary Incontinence during the Menopausal Transition and Early Postmenopause

Outcomes of Urinary Incontinence during the Menopausal Transition and Early Postmenopause. Nancy Fugate Woods, PhD, RN, FAAN Ellen Sullivan Mitchell, PhD. Acknowledgements.

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Outcomes of Urinary Incontinence during the Menopausal Transition and Early Postmenopause

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  1. Outcomes of Urinary Incontinence during the Menopausal Transition and Early Postmenopause Nancy Fugate Woods, PhD, RN, FAAN Ellen Sullivan Mitchell, PhD

  2. Acknowledgements • Data were collected with support from grants from the National Institute for Nursing Research, NIH, NR01 04141 and NINR, NIH, P50-NR-02323, P30-NR04001 • Data were analyzed with support from Pfizer, Inc

  3. Background • Urinary Incontinence (UI) becomes more prevalent as women age • With growing population of older women, incontinence is increasingly important topic • SUI peaks among women 40-59 years of age in the NHANES Study and UUI peaks between 80-89 years of age (Minassian et al, 2008)

  4. Background • Little is known about women’s experiences of urinary incontinence during midlife and the menopausal transition and early postmenopause • Although there have been studies of the prevalence of UI, including stress urinary incontinence and urge incontinence, there has been little effort to evaluate the outcomes of incontinence among this age group of women (Waetjen et al, 2006, 2007) • Past studies suggest that SUI and UUI have multiple outcomes influencing quality of life among older women

  5. MOOD STRESS UI SELF PERCEPTIONS ATTITUDES TOWARD MENOPAUSE AND AGING URGE UI CONSEQUENCES FOR DAILY LIVING

  6. Purposes • Determine the influence of SUI and UUI among midlife women, including: • Mood (anxiety, depressed mood) • Self perceptions (mastery, self esteem, perceived health) • Attitudes toward midlife (menopause and aging) • Consequences for daily living (relationships, work, sexual desire, physical activity, sleep, stress, social support)

  7. The Seattle Midlife Women’s Health Study

  8. Methods • Sample: A subset of Seattle Midlife Women’s Health Study for participants (n=299 with up to 2206 observations) who provided data during the late reproductive, early, and late menopausal transition stages and early postmenopause • Data: From menstrual calendars, annual health updates beginning in 1990, and provided symptom diaries • Analysis: Multilevel modeling with an r program was used to test models accounting for SUI and UUI outcomes

  9. Measures • STRESS URINARY INCONTINENCE • URGE URINARY INCONTINENCE • “Do you lose urine when you cough, sneeze, or lift?” • “Did you often have a severe sense of urgency before losing your urine?

  10. Measures • MOOD • SELF PERCEPTIONS • ANXIETY– health diary item • DEPRESSION– CESD Scale Radloff • SELF-ESTEEM – Rosenberg • MASTERY – Pearlin and Schooler • PERCEIVED HEALTH – health diary

  11. Measures • ATTITUDES TOWARD MIDLIFE • INTERFERENCE WITH DAILY LIVING • Attitudes to Menopause - Patsdaughter • Attitudes toward Aging – Patsdaughter • Interference – diary items • Sexual desire, physical activity, sleep, stress – diary item • Social support - Barerra

  12. ANALYSIS: RANDOM INTERCEPT AND RANDOM SLOPEMLM MODEL(AGE CENTERED AT MEAN) yij= β1 + b1,i+ b2,i(xij − 47.5) + εij

  13. MOOD - depressed Beta = 1.12, p= .06 URGE UI Beta = -.31, p<.001 (SE) Beta = -.36, p<.001 (Ma) PERCEPTIONS OF ONESELF – self esteem, mastery Beta = -.19, p=.01 (SE) Beta = -.20, p=.004 (Ma) STRESS UI CONSEQUENCES OF STRESS AND URGE URINARY INCONTINENCE

  14. Conclusions • SUI and UUI during the menopausal transition and early postmenopause primarily affect a woman’s perception of herself, including her self esteem and mastery • A marginal effect of UUI on depressed mood merits further study and may herald a different set of outcomes for women with UUI and SUI • Both SUI and UUI influence women’s experiences of embodiment and expose them to stigmatizing conditions • A lifespan view of UI is needed to construct women-centered therapies to help women regain a sense of mastery and self esteem

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